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Early warning scores

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https://www.readbyqxmd.com/read/27907062/sepsis-prevalence-and-outcome-on-the-general-wards-and-emergency-departments-in-wales-results-of-a-multi-centre-observational-point-prevalence-study
#1
Tamas Szakmany, Robert M Lundin, Ben Sharif, Gemma Ellis, Paul Morgan, Maja Kopczynska, Amrit Dhadda, Charlotte Mann, Danielle Donoghue, Sarah Rollason, Emma Brownlow, Francesca Hill, Grace Carr, Hannah Turley, James Hassall, James Lloyd, Llywela Davies, Michael Atkinson, Molly Jones, Nerys Jones, Rhodri Martin, Yousef Ibrahim, Judith E Hall
Data on sepsis prevalence on the general wards is lacking on the UK and in the developed world. We conducted a multicentre, prospective, observational study of the prevalence of patients with sepsis or severe sepsis on the general wards and Emergency Departments (ED) in Wales. During the 24-hour study period all patients with NEWS≥3 were screened for presence of 2 or more SIRS criteria. To be eligible for inclusion, patients had to have a high clinical suspicion of an infection, together with a systemic inflammatory response (sepsis) and evidence of acute organ dysfunction and/or shock (severe sepsis)...
2016: PloS One
https://www.readbyqxmd.com/read/27875727/predictor-of-left-ventricular-dysfunction-after-aortic-valve-replacement-in-mixed-aortic-valve-disease
#2
Alexander C Egbe, Carole A Warnes
BACKGROUND: The fate of the left ventricle (LV) after aortic valve replacement (AVR) in mixed aortic valve disease (MAVD) is unknown. METHODS: Patients with moderate-severe MAVD, ejection fraction ≥50%, and no coronary artery disease who underwent AVR were identified. Moderate-severe MAVD was defined as a combination of ≥moderate aortic stenosis and ≥moderate aortic regurgitation. Assessment for LVD was performed at 1 and 5years after AVR. The purpose of the study was to determine prevalence and predictors of early and late left ventricular dysfunction (LVD) defined as ejection fraction <50% at 1 and 5years post-AVR...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27868189/an-evaluation-of-inpatient-morbidity-and-critical-care-provision-in-zambia
#3
P J Dart, J Kinnear, M D Bould, S L Mwansa, Z Rakhda, D Snell
The aim of this study was to objectively measure demand for critical care services in a southern African tertiary referral centre. We carried out a point prevalence study of medical and surgical admissions over a 48-h period at the University Teaching Hospital, Lusaka, recording the following: age; sex; diagnosis; Human Immunodeficiency Virus (HIV) status and National Early Warning Score. One-hundred and twenty medical and surgical admissions were studied. Fifty-four patients (45%) had objective evidence of a requirement for critical care review and potential or probable admission to an intensive care unit, according to the Royal College of Physicians (UK) guidelines...
November 21, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27865003/capturing-early-signs-of-deterioration-the-dutch-early-nurse-worry-indicator-score-denwis-and-its-value-in-the-rapid-response-system
#4
Gooske Douw, Getty Huisman-de Waal, Arthur R H van Zanten, Johannes G van der Hoeven, Lisette Schoonhoven
OBJECTIVES: To determine the predictive value of individual and combined DENWIS-indicators at various Early-Warning-Score (EWS)-levels, differentiating between EWSs reaching the trigger-threshold to call an RRT and EWS-levels not reaching this point. INTRODUCTION: DENWIS comprises nine indicators underlying nurses' 'worry' about a patients' condition. All indicators independently show significant association with unplanned Intensive-Care/High-Dependency-Unit (ICU/HDU)-admission or unexpected mortality...
November 16, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27863876/scoping-review-the-use-of-early-warning-systems-for-the-identification-of-in-hospital-patients-at-risk-of-deterioration
#5
REVIEW
Marie Danielle Le Lagadec, Trudy Dwyer
INTRODUCTION: Early warning systems (EWS) were developed as a means of alerting medical staff to patient clinical decline. Since 85% of severe adverse events are preceded by abnormal physiological signs, the patient bed-side vital signs observation chart has emerged as an EWS tool to help staff identify and quantify deteriorating patients. There are three broad categories of patient observation chart EWS: single or multiple parameter systems; aggregated weighted scoring systems; or combinations of single or multiple parameter and aggregated weighted scoring systems...
November 15, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27858814/moving-beyond-single-parameter-early-warning-scores-for-rapid-response-system-activation
#6
Matthew M Churpek, Dana P Edelson
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850864/1228-does-a-multiparameter-early-warning-scoring-system-predict-clinical-deterioration
#7
Jill Williams, Ellie Olson, James Kelly
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850827/1191-validation-of-a-pediatric-early-warning-score-in-a-pediatric-oncology-hospital-in-guatemala
#8
Asya Agulnik, Alejandra Mendez, Lupe Mora, Peter Forbes, Dora Soberanis, Ricardo Mack, Monica Kleinman, Carlos Rodriguez-Galindo
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27832561/improved-hospital-mortality-with-a-low-met-dose-the-importance-of-a-modified-early-warning-score-and-communication-tool
#9
D V Mullany, M Ziegenfuss, M A Goleby, H E Ward
Rapid response systems have been mandated for the recognition and management of the deteriorating patient. Increasing medical emergency team (MET) dose may be associated with improved outcomes. Large numbers of MET calls may divert resources from the program providing the service unless additional personnel are provided. To describe the implementation and outcomes of a multifaceted rapid response system (RRS) in a teaching hospital, we conducted an observational study. The RRS consisted of the introduction of a MET together with 1) redesign of the ward observation chart with the vital sign variables colour-coded to identify variation from normal; 2) mandated minimum frequency of vital sign measurement; 3) three formal levels of escalation based on the degree of physiological instability as measured by a modified early warning score (MEWS); 4) COMPASS© education and e-learning package with a two-hour face-to-face small group tutorial; 5) practise in escalation and communication using the ISBAR (Identify, Situation, Background, Assessment, Response/Recommendation) communication tool...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27832032/accuracy-and-efficiency-of-recording-pediatric-early-warning-scores-using-an-electronic-physiological-surveillance-system-compared-with-traditional-paper-based-documentation
#10
Gerri Sefton, Steven Lane, Roger Killen, Stuart Black, Max Lyon, Pearl Ampah, Cathryn Sproule, Dominic Loren-Gosling, Caitlin Richards, Jean Spinty, Colette Holloway, Coral Davies, April Wilson, Chung Shen Chean, Bernie Carter, E D Carrol
Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score...
November 9, 2016: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/27823915/validation-of-the-children-s-hospital-early-warning-system-for-critical-deterioration-recognition
#11
Mary C McLellan, Kimberlee Gauvreau, Jean Anne Connor
OBJECTIVE: Early warning scores, such as the Children's Hospital Early Warning Score (CHEWS), are used by hospitals to identify patients at risk for critical deterioration and trigger clinicians to intervene and prevent further deterioration. This study's objectives were to validate the CHEWS and to compare the CHEWS to the previously validated Brighton Pediatric Early Warning Score (PEWS) for early detection of critical deterioration in hospitalized, non-cardiac patients at a pediatric hospital...
November 4, 2016: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/27814440/views-from-the-prehospital-perspective-a-comparison-with-a-prehospital-score-to-triage-categorisation-in-the-emergency-department
#12
D Gaumont, N Cummins, A Hannigan, D Ryan
This aim of this observ estigate how the recently introduced National Early Warning Score (ViEWS) applied in the prehospital setting (Ph-ViEWS) compares with the Manchester Triage System (MTS) used in most Emergency Departments (ED) in Ireland. 386 patients fitted the inclusion criteria of which 272 (69%) had a complete set of values. Of 272 MTS 1 and 2 patients, only 114 (42%) had a Ph-ViEWS ⋝7. This study found that a substantial number of patients deemed urgent at the time of triage do not have elevated Ph-ViEWS...
June 10, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/27811448/the-comparison-of-modified-early-warning-score-and-glasgow-coma-scale-age-systolic-blood-pressure-scores-in-the-assessment-of-nontraumatic-critical-patients-in-emergency-department
#13
Ö Köksal, G Torun, E Ahun, D Sığırlı, S B Güney, M O Aydın
INTRODUCTION: The purpose of this study is to assess and compare the discriminatory ability of the Glasgow coma scale (GCS)-age-systolic blood pressure (GAP) score and modified early warning scoring system (mEWS) score for 4-week mortality, for the patients being in the triage category 1 and 2 who refer to Emergency Department (ED). METHODS: Five hundred and two nontraumatic cases being in the triage category 1 and 2 who were ≥18-year-old and who referred to ED were assessed prospectively...
November 2016: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27805798/incorporating-an-early-detection-system-into-routine-clinical-practice-in-two-community-hospitals
#14
B Alex Dummett, Carmen Adams, Elizabeth Scruth, Vincent Liu, Margaret Guo, Gabriel J Escobar
Efforts to improve outcomes of patients who deteriorate outside the intensive care unit have included the use of rapid response teams (RRTs) as well as manual and automated prognostic scores. Although automated early warning systems (EWSs) are starting to enter clinical practice, there are few reports describing implementation and the processes required to integrate early warning approaches into hospitalists' workflows. We describe the implementation process at 2 community hospitals that deployed an EWS. We employed the Institute for Healthcare Improvement's iterative Plan-Do-Study-Act approach...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27805795/piloting-electronic-medical-record-based-early-detection-of-inpatient-deterioration-in-community-hospitals
#15
Gabriel J Escobar, Benjamin J Turk, Arona Ragins, Jason Ha, Brian Hoberman, Steven M LeVine, Manuel A Ballesca, Vincent Liu, Patricia Kipnis
Patients who deteriorate in the hospital outside the intensive care unit (ICU) have higher mortality and morbidity than those admitted directly to the ICU. As more hospitals deploy comprehensive inpatient electronic medical records (EMRs), attempts to support rapid response teams with automated early detection systems are becoming more frequent. We aimed to describe some of the technical and operational challenges involved in the deployment of an early detection system. This 2-hospital pilot, set within an integrated healthcare delivery system with 21 hospitals, had 2 objectives...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27804076/the-predictive-value-of-the-modified-early-warning-score-with-rapid-lactate-level-views-l-for-mortality-in-patients-of-age-65-or-older-visiting-the-emergency-department
#16
Hasan Basri Cetınkaya, Ozlem Koksal, Deniz Sigirli, Emrah Habip Leylek, Ozlem Karasu
The purpose of this study is to detect the predictive power of the modified early warning score with rapid lactate level (ViEWS-L) on mortality in critical patients over the age of 65 years admitted to the emergency department (ED). A total of 616 non-traumatic patients admitted to the Uludag University Faculty of Medicine ED who were 65 years of age or older were included in this study (Ethics board number: 2015-4/8). In this prospective study; the ViEWS-L score of the patients were calculated. The results have been evaluated with rate of mortality in the first 24 h starting from submission...
November 1, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27783733/modified-early-warning-score-evaluation-of-trauma-patients
#17
Thaís Flôr da Rocha, Juliana Gibbon Neves, Karin Viegas
Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48...
September 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27783731/translation-and-adaptation-of-a-pediatric-early-warning-score
#18
Juliana de Oliveira Freitas Miranda, Climene Laura de Camargo, Carlito Lopes Nascimento, Daniel Sales Portela, Alan Monaghan, Katia Santana Freitas, Renata Fonseca Mendoza
Objective: to translate and adapt the BPEWS for the Portuguese language, with the purpose of verifying its applicability in the Brazilian context studied. Method: methodological study guided by international and nationally accepted recommendations for translation and adaptation of health measurement instruments. Stages of conceptual, item, semantic, operational and pre-test equivalence are described for obtaining the BPEWS Portuguese version to be used in Brazil...
September 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27766526/implementation-of-a-novel-postoperative-monitoring-system-using-automated-modified-early-warning-scores-mews-incorporating-end-tidal-capnography
#19
Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27765032/association-between-olfactory-identification-and-cognitive-function-in-community-dwelling-elderly-the-shanghai-aging-study
#20
Xiaoniu Liang, Ding Ding, Qianhua Zhao, Qihao Guo, Jianfeng Luo, Zhen Hong
BACKGROUND: The smell sense reduction was considered to represent the potentially warning of early stage of neurodegenerative disorders. The Shanghai Aging Study provided us a unique opportunity to explore the association between olfactory identification (OI) and cognitive function among community-dwelling elderly in China. METHODS: OI of each participant was measured by the 12-item identification tests from Sniffin' Sticks Screening test (SSST-12). Participants with mild cognitive impairment (MCI) were diagnosed by Petersen criteria...
October 20, 2016: BMC Neurology
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